Medical Journal of the Islamic Republic Of Iran

en The Role of 2-Dimensional and 3-Dimensional Speckle Tracking Echocardiography in Detecting Early Myocardial Dysfunction in Obstructive Sleep Apnea Patients Cardiology Cardiology Original Research Original Research Background: Obstructive sleep apnea (OSA), a worldwide prevalent sleep-related breathing disorder, is associated with an increased rate of cardiovascular disease (CVD) incidence and higher all-cause mortality. Evidence demonstrates that OSA can contribute to subclinical cardiac damage and lead to a significantly higher risk of future heart failure. Speckle tracking echocardiography (STE) is a new technique that is useful for detecting subclinical dysfunction in patients without clinical manifestations of cardiac problems and who have normal conventional echocardiography. This review examines the application of STE for the early detection of subclinical dysfunction in all four heart chambers of individuals with OSA.    Methods: To provide an in-depth overview of the current evidence in this review study, we conducted a broad literature search across 4 major databases—PubMed, Scopus, Embase, and Web of Science—in July 2025. Keywords and combinations related to “speckle tracking echocardiography,” “global longitudinal strain,” “left atrium,” “left ventricle,” “right atrium,” “right ventricle,” and “obstructive sleep apnea” were used to identify relevant studies. We aimed to explore studies examining subtle functional alterations in cardiac chambers among patients with OSA using STE. Systematic reviews, meta-analyses, case reports, abstracts, letters, conference proceedings, and non-English publications were excluded to maintain focus on original research and clinical insights.    Results: After screening by title/abstract and full-text review, from a total of 145 studies, 29 were included based on the best match with our inclusion criteria. Our key finding in this systematic review were as follows: (1) left atrium (LA) subclinical systolic and early diastolic strain/strain rate decrease before alteration in conventional echocardiography indexes; (2) left ventricle (LV) early detectable strain/strain rate decrease in all its 3 contracting directions (longitudinal, circumferential, and radial); (3) subtle changes in LV myocardial work index (MWI); (4) valuable information about early strain changes in different directions of RV wall contraction despite its complex geometry.    Conclusion: Our study highlighted available studies describing subclinical strain and strain rate alterations in each cardiac chamber through speckle tracking echocardiography and addresses this method’s feasibility to detect early changes in myocardium as a result of OSA.   Speckle Tracking Echocardiography, Obstructive Sleep Apnea, Strain Value, Strain Rate, Global Longitudinal Strain, Area Strain, Subclinical Dysfunction, LV Torsion 1089 1098 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8912-1&slc_lang=en&sid=1 Yasmin Mohtasham Kia yasmin.mkia@gmail.com 200319475328460093745 200319475328460093745 No Vascular Disease and Thrombosis Research Center, Rajaie Cardiovascular Institute, Tehran, Iran Ali Haji Mohammadi a_haji77@hotmail.com 200319475328460093746 0009-0008-8915-0975 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Sepideh Emami sepideh_emami@yahoo.com 200319475328460093747 200319475328460093747 No Cardiology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mehrdad Barati Barati.me@iums.ac.ir 200319475328460093748 0009-0004-5809-2494 Yes Cardiology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran